Tourette syndrome begins in childhood and may surface intermittently, with tics changing in type, frequency and intensity. Tics are repetitive sounds or movements that the child cannot control, and which can come in bursts.
Simple tics involve one muscle or simple found, while complex tics involve movement of several muscles, or the saying of a phrase.
Sometimes tics are barely noticeable but in other children they may be more intense and distracting which can make classroom activities difficult. They may last for a certain period and then disappear, only to be replaced with another tic.
Changes in the location and frequency of tics is known as “waxing and waning”.
What causes Tourette syndrome?
The exact cause of Tourette syndrome is unclear but is thought to result from a combination of genetics and environmental factors, affecting brain regions like the basal ganglia and neurotransmitters, such as dopamine. Individuals with a family history of the condition are at a higher risk.
Other potential influences include prenatal factors, such as birth complications or maternal smoking, and autoimmune processes linked to infections.
Boys are three to four times more likely to be affected than girls.
Some examples of tics:
- Simple motor tics: eye blinking, head jerks, nose twitching, facial grimacing, shoulder shrugs
- Simple vocal tics: grunting, squeaking, coughing, whistling, humming, spitting
- Complex motor tics: pulling at clothes, touching people/objects, twirling around, self-injurious behaviour
- Complex vocal tics: animal-like sounds, unusual changes in pitch or volume, swearing
Supporting a pupil with Tourette in the classroom
Children and young people with tic disorders may need support in the classroom to make them feel safe and understood. They may experience teasing or bullying and find some schoolwork and activities difficult, especially reading, writing and maths. Raising awareness in the child’s class – and in school generally – will help the child feel supported and nurtured and help to avoid bullying.
- Consult with parents and carers to find out what strategies work
- Do not punish tics and try to ignore them as much as possible. Commenting or drawing attention to tics can make them worse. Fidget toys might be helpful
- Ensure all teachers are aware that the child displays tics and provide information about how to respond
- Seating the child to the side of a class, and away from a window might be helpful. Extra personal space might be needed if the child has a large motor tics
- If writing is difficult, offer other means of producing work, such as computer programmes, oral report, or voice recording. The pupil might also need additional time to complete tasks and assessments, and a separate room for exams
- Break up tasks into smaller chunks so they are not overwhelming. Stress can make tics worse
- Raise their self-esteem with praise for achievement and encourage them to speak about their feelings and condition. A learning mentor might be helpful to a child with Tourette
- Encourage participation in sport or other physical movement as this can reduce stress and so decrease tics
- Ensure that consequences for inappropriate behaviours are suitable
- Tourette can cause fatigue and require increased calorie intake, so the child might need snacks between meals
- Tourette can sometimes be accompanied by compulsive disorders so liaise with the mental health team for further advice
Regular consultation with parents, professionals, colleagues and the young person will help to reduce some of the frustrations associated with Tourette syndrome and support the child in their learning.
*For further information go to https://www.tourettes-action.org.uk/rescat-2-children–young-people.html and Challenging Kids, Challenged Teachers: Teaching Students with Tourette’s, Bipolar Disorder, Executive Dysfunction, OCD, AD/HD and More (2010) by Leslie Packer and Sheryl Pruitt SK (Woodbine House Inc, ISBN 1 890 627 828)
